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Once upon a time, kids who wore braces were teased by their peers with mean-spirited nicknames such as brace face, tinsel teeth, zipper lips and metal mouth. These days, however, braces have become seemingly as ubiquitous as eyeglasses, almost a rite of passage for American youth in their formative years. Studies have estimated anywhere from 50-70 percent of American children will wear braces between the ages of 6-18.

Children from ages 6-18 (and even some adults) typically get braces to correct malocclusions (i.e., bad bites). These jaw or tooth alignment problems are usually genetic, but can result from an injury, early or late tooth loss or thumb-sucking.1 Historically, most children started wearing braces in their early- and into mid-adolescent years, after all of their permanent teeth had erupted (ages 11-15), but in more recent years there has been a trend towards earlier intervention to take advantage of high rates of growth and to correct certain conditions that might otherwise adversely affect growth and development. Crowded, poorly-positioned teeth not only affect a child’s appearance, but can negatively impact the way a child bites, chews and speaks, and can increase the long-term potential for developing periodontal disease or temporomandibular joint (TMJ) problems.1

Whether or not they have braces, kids should always eat a healthy diet. In general, however, kids with braces should avoid foods that are difficult to bite off or chew, that may damage the braces, or that are difficult to clean from around the wires and attachment brackets. Foods like popcorn, corn on the cob, whole apples, sunflower seeds and sticky candy fall into these categories. It is also not a good idea to chew on ice, pencils or any other oral habits that can bend the wires or otherwise damage the appliances that go into moving teeth into proper position.2 Eating too many sticky and sugary foods is particularly damaging to children with braces, since plaque tends to build-up around the appliances and can lead to decay where the brackets are attached to the teeth.

Standard oral health care best practices apply to all children – with or without braces. This includes brushing with fluoride toothpaste and flossing daily, wearing a properly fitting mouthguard during contact sports, and making regular dental visits. Obviously brushing and flossing presents some challenges while wearing braces but the child’s dental team will usually provide the proper guidance on facing the challenges to good oral hygiene that wearing braces can present. This may include things like using fluoride rinses, floss threaders, interproximal cleaners, powered brushes or irrigators, dental wax and other tips for keeping the braces and teeth clean and wearing them comfortably.

A child’s teeth are often sore for a day or two after the braces are first put on or after an adjustment appointment. In addition, other typical problems that children may have to deal with include food caught between the teeth and appliance, one or more of the little rubber bands break that hold the wires to the bracket, a wire breaks and pokes into the cheek, a sore develops on the cheek or gum where something is rubbing.
1.American Dental Association. “Braces” http://www.mouthhealthy.org/az-topics/b/braces.aspx
2.American Dental Association 2010 Survey of Dental Practice
3.American Association of Orthodontists. http://www.mylifemysmile.org/faq

Although cavities are nearly 100 percent preventable, more than one out of four American caregivers reported that their children had a cavity filled in the past year. This was among the findings of a new survey1 of nearly 1,000 caregivers released today by Delta Dental in conjunction with National Children’s Dental Health Month. Among children who had a cavity in the past year, 53 percent had two or more cavities.

The 2013 Delta Dental Children’s Oral Health Survey shows that not only are Americans unaware they can pass cavity-causing bacteria to children, but they also need to brush up on some critical children’s dental health habits, including basics such as brushing and flossing.

Parents and caregivers need to teach good oral health habits to children at a young age to help prevent cavities. Baby teeth are very important. They help children chew and speak properly and hold space for permanent teeth. If a child has healthy baby teeth, chances are he or she will have healthy adult teeth.

These are some of the oral health habits that fall short of what’s recommended by dental professionals:

• Survey shows: Seventy-five percent of caregivers say they share utensils such as a spoon, fork, or glass with a child.
• Delta Dental recommends: Parents and caregivers should eliminate saliva-transferring behaviors – such as sharing utensils and toothbrushes and cleaning a pacifier with their mouths – all activities which can pass harmful bacterial to a child.

• Survey shows: Forty-nine percent of Americans with a child four years or younger report that the child sometimes takes a nap or goes to bed with a bottle or sippy cup containing milk or juice.
• Delta Dental recommends: Parents and caregivers should not put a child to bed with a bottle of milk, juice, sweetened water or soft drinks, which can lead to baby bottle decay. Instead, caregivers should fill the bottle with water.

• Survey shows: For children who have visited the dentist, the average age at the first visit was 3 years old.
• Delta Dental recommends: Children should first visit the dentist within six months of getting the first tooth – and no later than the first birthday.

• Survey shows: Only 58 percent of children had their teeth brushed twice a day and 34 percent of children brush for less than two minutes.
• Delta Dental recommends: Children’s teeth should be brushed twice a day for at least two minutes each time. Parents should assist with this task until the kids are about 6 years old.

• Survey shows: Forty-three percent of parents or caregivers report that their children’s teeth are never flossed, and of children whose teeth are flossed, only 23 percent are flossed daily.
• Delta Dental recommends: Once any two teeth are touching, caregivers should floss, or help the child floss, once a day.

1 Morpace Inc. conducted the 2013 Delta Dental Children’s Oral Health Survey. Interviews were conducted nationally via the Internet with 926 primary caregivers of children from birth to age 11. For results based on the total sample of national adults, the margin of error is ±3.2 percentage points at a 95 percent confidence level.

According to the National Institutes of Health, more than 20 million Americans avoid going to the dentist out of fear.

Most dentists are well aware of their patients’ anxieties. They try to create a soothing environment where patients can feel calm and comfortable, beginning with an inviting waiting room and a caring, attentive staff. Some practices offer television, music, or even virtual reality glasses to entertain and distract nervous patients in the chair. Others employ pillows, blankets or aromatherapy to help their patients relax.

But one practitioner has found a unique solution to help his young patients conquer their dental phobia. The clinic of Dr. Paul Weiss, a pediatric dentist in Williamsville, N.Y., recently posted a photo on the popular website reddit that showed how he uses his golden retriever Brooke to act as a therapy dog to calm nervous young patients. According to MSN.com, Brooke is bathed before each visit and Weiss’s office is cleaned after she leaves to maintain proper sanitation.

Did you know Americans consumed 24.7 pounds of candy per capita in 2010?1 That’s a lot of sugar to potentially cause cavities if left on the teeth of boys and ghouls too long. After eating candy, Delta Dental recommends a thorough brushing of teeth (or at least a big drink of water).

Since Halloween is a favorite holiday of many Americans, Delta Dental has compiled a list of the 10 best terrifically terrifying truths:

1. Americans purchase nearly 600 million pounds of candy for Halloween each year.2

2. Major pumpkin-producing states like California, Illinois, New York and Ohio helped America grow 1.1 billion pounds of pumpkins in 2010.3

3. Sixty percent of dentists polled for Delta Dental’s Tricky Treats survey said they give out candy on Halloween. Of the dentists who dispense candy, 79 percent choose chocolate, while just 13 percent hand out varieties like hard candy or lollipops. This confectionary choice is no accident. Chocolate dissolves quickly in the mouth and can be eaten easily, which decreases the amount of time sugar stays in contact with teeth.4

5. About 50 percent of Americans decorated their homes or yards, 44 percent dressed in a costume, 34 percent attended a Halloween party and 23 percent visited a haunted house in 2011.2

6. In 2011, the three most popular costumes worn by children were Harry Potter, princess and Green Lantern. Classic characters like Winnie the Pooh, Elmo and the Smurfs were also among the top 10 favorites. Captain America, Green Lantern and Where’s Waldo were popular costume choices for adults.5

7. Nearly one out of four dentists said they do not hand out anything on Halloween, while five percent attack the holiday head on by handing out toothbrushes.4

8. Not everyone gives out candy on Halloween. Ideas include toothbrushes, pretzels, fruit (such as raisins), modeling clay and books.4

9. An estimated 41 million children between the ages of five and 14 went trick-or-treating across the U. S. in 2010.1

10. Candy corn, a popular treat commonly associated with Halloween, was created in the 1880s and popularized by farmers who appreciated its resemblance to kernels of corn. 6

To learn more about what dentists give out at Halloween and get their best advice for keeping kids’ teeth healthy, please visit http://www.trickytreats.org.

4 Delta Dental conducted the 2011 Tricky Treats Halloween survey. Delta Dental network dentists were invited via e-mail to participate in the web-based survey. For results based on the total sample of 253, the margin of error is ±6.15 percentage points at a 95 percent confidence level.

Why is 80 percent of tooth decay found in only 25 percent of children, disproportionately kids from low-income families?1 The answer is multifold and complex, but Delta Dental believes that school-based dental sealant programs are a large part of a workable solution.

Dental sealants are a critical but underutilized component of preventive dentistry. The one-two punch of sealants and fluoride (in toothpaste and water) along with a proper diet can almost totally prevent new tooth decay.

National surveys by the Centers for Disease Control and Prevention (CDC) indicate that only 38 percent of children and teenagers ages 12 to 19 have dental sealants. This number is much lower among children from low-income families and certain races/ethnicities with higher tooth decay rates who would benefit most from sealants.1

Dental sealants can save families time, money and the discomfort of dental fillings. Sealants are thin, plastic coatings applied to the pits and grooves of teeth to protect them from the bacteria and foods that lead to tooth decay. First and second permanent molars are the most likely to benefit from sealants, so it’s best if the sealant is applied soon after those teeth appear, before they have a chance to decay (usually ages 6 and 12).

A sealant is virtually 100 percent effective if fully retained on the tooth, and studies have shown they remain intact 92 to 96 percent of the time after one year and 67 to 82 percent after five years. Sealants should be checked at each regular dental appointment and can be reapplied if they are no longer in place. 2

Sealants delivered through school-based programs have been shown to decrease tooth decay by 60 to 65 percent.3 Using school-based sealant programs at lower-income schools has proven to be highly effective in improving the oral health of those schoolchildren. Studies of children in either Medicaid programs or with private dental insurance show that placement of sealants on first and second permanent molars reduced the need for future cavity fillings.

It may seem like a mindless matter, but packing an apple instead of a sugary snack in a child’s lunch this fall can help improve oral health and educational performance. After all, children eat more than 20 percent of their meals at school during the academic year. So Delta Dental, the nation’s largest dental benefits provider, reminds parents to make good decisions when packing a child’s school lunch.

Overconsumption of sugar harms a child’s oral and overall health. Snacks like cookies, candy and chewy fruit snacks mix with bacteria in the sticky plaque that constantly forms on teeth to generate acid, which can wear away enamel and cause tooth decay. While sweets may provide a temporary jolt for kids, that sugar rush soon turns into a crash and kids are left feeling lethargic. That is not the kind of mental state kids need to prepare for an afternoon of classes.

Instead, Delta Dental recommends these top five oral health best practices:

• After breakfast, before leaving for school, make sure your child brushes well with a fluoridated toothpaste. Brushing immediately following a meal helps clean teeth and eliminates halitosis (bad breath).

• Fill a child’s lunch box with healthy lunch food and snacks such as lean meats, whole grain breads, low-fat yogurt or cheeses, apples, bite-size carrots and baked chips or whole-grain crackers. Besides being packed with nutrients, certain fruits and veggies can even help clean the teeth and gums. Make treats a treat. Serve sugary sticky snacks like cookies, cake and brownies and candy only in moderation. Room parents should discuss bringing in healthy snacks along with sugary treats for birthdays and other classroom parties.

• If a child chews gum and the school allows it, chewing sugar-free gum for a few minutes in between lunch and afternoon classes can help stimulate saliva to buffer the acid and help dislodge food particles from the mouth. Gum containing the natural sweetener, Xylitol, is a particularly good option since studies have shown that consistent exposure to Xylitol can reduce cavity-causing bacteria in the mouth.

• Children with braces should try to brush or rinse well with water after lunch. Children who wear removable retainers should clean them well after each meal and rinse out their mouths.

• Before the school year starts, schedule a dental visit to make sure there are no problems to distract a child during the school year. Ask the dentist about sealants as a way to protect children’s teeth from cavities. Sealants – a thin coating of bonding material applied over the chewing surface of molar teeth – act as a barrier to cavity-causing bacteria.

Along with an annual physical, clothes and backpacks, Delta Dental suggests adding a visit to the dentist to your child’s back-to-school list this fall. Dental professionals recommend biannual visits for most children, and the end of summer is an ideal time because it follows a season in which kids have indulged in treats like soda, ice cream and cotton candy.

A dental visit is important because a dentist can diagnose potential oral health problems such as tooth decay or gum disease and apply preventive measures as needed, including teeth cleaning, fluoride treatment, dental sealants, and instruction on good dental hygiene habits. Making sure children get a clean bill of oral health before the school year allows them to return to class flashing a happy and healthy smile. Conversely, untreated dental problems can be painful and embarrassing, and can harm a child’s educational and social development. In 2007, for example, the State of California estimated that seven percent of their more than seven million schoolchildren (504,000) missed at least one day of school because of a dental problem. 1

Unfortunately, access to sufficient dental care is not nearly what it needs to be for children from poor and uninsured families. A study from the Pew Center on the States found that two-thirds of states in the U.S. do not have adequate policies in place to ensure access to proper preventive dentistry, particularly for those children that lack appropriate access to care. 2 Instead, programs like mobile dental units that visit schools and school-based dental sealant programs are playing a critical part in improving the oral health and quality of life of low-income, American children.

Ultimately, good oral health for children starts at home with proper dental hygiene and diet. The daily one-two punch of brushing twice a day with a fluoride toothpaste and flossing once is still the foundation for maintaining healthy teeth and gums. Very young children (ages one to five) are particularly prone to tooth decay and parents should supervise (or actually brush) to make sure they do a good job. A diet light on sugary snacks and drinks and rich in fruits and vegetables goes a long way toward maintaining good oral and overall health.